Beta-blocker under-use in COPD patients

Background: Cardiovascular (CVS) comorbidities are common in COPD and contribute significantly to morbidity and mortality, especially following acute exacerbations of COPD (AECOPD). Beta-blockers (BBs) are safe and effective in COPD patients, with demonstrated survival benefit following myocardial infarction. We sought to determine if BBs are under-prescribed in patients hospitalized with AECOPD. We also sought to determine inpatient rates of CVS and cerebrovascular complications, and their impact on patient outcomes. Methods: Retrospective hospital data was collected over a 12-month period. The medical records of all patients 40 years of age coded with a diagnosis of AECOPD were analyzed. Prevalent use and incident initiation of BBs were assessed. Comorbidities including indications and contraindications for BB use were analyzed. Results: Of the 366 eligible patients, 156 patients (42.6%) had at least one indication for BB use – of these patients, only 53 (34.0%) were on BB therapy and 61 (39.1%) were not on BB therapy but had no listed contraindication. Prevalent use of BBs at the time of admission in all 366 patients was 19.7%, compared with 45.6%, 39.6% and 45.9% use of anti-platelets, statins and angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers, respectively. CVS and cerebrovascular complications were common in this population (57 patients, 16%) and were associated with longer length of stay (p,0.01) and greater inpatient mortality (p=0.02). Conclusions: BBs are under-prescribed in COPD patients despite clear indication(s) for their use. Further work is required to explore barriers to BB prescribing in COPD patients

Population-scale organization of cerebellar granule neuron signaling during a visuomotor behavior.

Granule cells at the input layer of the cerebellum comprise over half the neurons in the human brain and are thought to be critical for learning. However, little is known about granule neuron signaling at the population scale during behavior. We used calcium imaging in awake zebrafish during optokinetic behavior to record transgenically identified granule neurons throughout a cerebellar population. A significant fraction of the population was responsive at any given time. In contrast to core precerebellar populations, granule neuron responses were relatively heterogeneous, with variation in the degree of rectification and the balance of positive versus negative changes in activity. Functional correlations were strongest for nearby cells, with weak spatial gradients in the degree of rectification and the average sign of response. These data open a new window upon cerebellar function and suggest granule layer signals represent elementary building blocks under-represented in core sensorimotor pathways, thereby enabling the construction of novel patterns of activity for learning

Ecomspaces: Warehouse Workflow Optimization

Ecomspaces specializes in fulfillment services for e-commerce businesses, providing as a full-service provider for storage, shipping, and rental office space solutions. RelayShopUSA focuses on parcel forwarding services to both domestic and French international customers. The two services operate under the same roof and utilize near-identical resources. For the sake of simplicity, both services will be referenced throughout this document as Ecomspaces. Ecomspaces has been experiencing difficulty in accepting and handling a greater volume of clients due to infrastructure-related problems within their warehouse. Management is seeking the development of both scalable and sustainable systems to cut costs and achieve long-term growth for their operation. This summarizes the strategies that have been proposed and implemented by the Optimized Brain E-spaces team to benefit the overall warehouse operation through (1) the implementation of layout changes to optimize workflow and to regain floor space throughout the facility, (2) the standardization of the safety, housekeeping, and maintenance of the warehouse, (3) the development of accessible and robust key performance indicators and standard operating procedures necessary for process improvement. These goals have been accomplished through the collection and statistical analysis of time and motion study data, alongside raw historical data obtained from reports generated by Ecomspaces warehouse management systems. Several tools and methodologies have been utilized in this scenario which include (1) project management tools such as project charter, work breakdown structure, Gantt chart, financial planning/budgeting, and economic analysis, (2) Six Sigma tools such as pareto charts, process flowchart, critical to quality, key process indicators, cause and effect diagram, and the DMAIC process, and (3) traditional industrial and systems engineering tools such as time and motion studies, spaghetti diagram, and system modeling/simulation. Our team’s design proposal is based on the evaluation of both current-state and possible future-states of the warehouse through computer modeling with ARENA simulation. This information was supplemented with on-site visits to conduct interviews for management and employees, completed audits for OSHA requirements pertaining to warehouse safety and maintenance, and foundational understanding of the work-processes within the operation to develop baseline productivity levels and standard times for each station. Regarding our team’s three suggested facility layout changes, we recommend the implementation of our proposed solution A, involving the consolidation of oversized/palletized inventory to be placed adjacent to the wall between the receiving and loading docks, and to add a fourth shipping in the dock 2 area (not being utilized previously). This optimal solution was identified through TOPSIS analysis

Collision Mitigation System: Pedestrian Test Target, Final Design Report

Daimler Trucks North America is creating an advanced emergency braking system which uses radar sensors that detect pedestrians and automatically applies the brakes to bring the vehicle to a stop. To improve and validate their technology, they need a mechanical pedestrian target that can mimic a human walking across the street. However, the assisted braking may not work properly during every test and the pedestrian target must be able to survive impact with a vehicle at low speeds. Four senior Mechanical Engineering students from California Polytechnic State University San Luis Obispo decided to take on the challenge. The main features of the test dummy are as follows: The dummy’s shoulders, elbows, and hips articulate under active servo control to imitate human gait. The soft limbs can be crushed without permanent damage. The mannequin rests on a platform that is translated by a pulley system. The speed of translation and frequency of gait vary with separate analog controllers. The mannequin falls off the platform away from the truck upon impact. The dummy survives an impact without serious damage and continues to function

Cellular uptake and anticancer activity of carboxylated gallium corroles

We report derivatives of gallium(III) tris(pentafluorophenyl)corrole, 1 [Ga(tpfc)], with either sulfonic (2) or carboxylic acids (3, 4) as macrocyclic ring substituents: the aminocaproate derivative, 3 [Ga(ACtpfc)], demonstrated high cytotoxic activity against all NCI60 cell lines derived from nine tumor types and confirmed very high toxicity against melanoma cells, specifically the LOX IMVI and SK-MEL-28 cell lines. The toxicities of 1, 2, 3, and 4 [Ga(3-ctpfc)] toward prostate (DU-145), melanoma (SK-MEL-28), breast (MDA-MB-231), and ovarian (OVCAR-3) cancer cells revealed a dependence on the ring substituent: IC_(50) values ranged from 4.8 to >200 µM; and they correlated with the rates of uptake, extent of intracellular accumulation, and lipophilicity. Carboxylated corroles 3 and 4, which exhibited about 10-fold lower IC_(50) values (> 3 > 2 >> 1 (intracellular accumulation of gallium corroles was fastest in melanoma cells). We conclude that carboxylated gallium corroles are promising chemotherapeutics with the advantage that they also can be used for tumor imaging

Alterations in Cortisol Profiles among Mothers of Children with ASD Related to Poor Child Sleep Quality

Caregivers of children with autism spectrum disorder (ASD) experience poorer sleep, but studies have not yet used objective measures to investigate how child and caregiver sleep affect each other. In this study, 29 mothers and their child with ASD aged between 6 and 16 years were recruited. Questionnaires measuring child autism, maternal depression, and maternal and child sleep quality were administered. Cortisol salivary samples were also obtained from the mothers over the course of a day. Results revealed that maternal depression is significantly correlated with their subjective sleep quality, sleep latency and daytime dysfunction. Child sleep quality was also found to be significantly correlated with ASD severity. In terms of maternal cortisol profiles, a significant number of mothers showed a flattened diurnal cortisol expression, and children of mothers with a flattened cortisol profile had significantly more sleep problems. Overall, results suggest that maternal and child sleep are affected by the child’s disability but also are mutually related. Future studies may consider employing measures such as actigraphy or somnography to quantify sleep quality and establish causal pathways between sleep, cortisol expression and caregiver and child outcomes. The present study has clinical implications in examining family sleep when considering treatment for ASD

Assessment of Swedish snus for tobacco harm reduction: an epidemiological modelling study

BACKGROUND: Swedish snus is a smokeless tobacco product that has been suggested as a tobacco harm reduction product. Our aim was to assess the potential population health effects of snus. METHODS: We assessed the potential population health effects of snus in Australia with multistate life tables to estimate the difference in health-adjusted life expectancy between people who have never been smokers and various trajectories of tobacco use, including switching from smoking to snus use; and the potential for net population-level harm given different rates of snus uptake by current smokers, ex-smokers, and people who have never smoked. FINDINGS: There was little difference in health-adjusted life expectancy between smokers who quit all tobacco and smokers who switch to snus (difference of 0.1-0.3 years for men and 0.1-0.4 years for women). For net harm to occur, 14-25 ex-smokers would have to start using snus to offset the health gain from every smoker who switched to snus rather than continuing to smoke. Likewise, 14-25 people who have never smoked would need to start using snus to offset the health gain from every new tobacco user who used snus rather than smoking. INTERPRETATION: Current smokers who switch to using snus rather than continuing to smoke can realise substantial health gains. Snus could produce a net benefit to health at the population level if it is adopted in sufficient numbers by inveterate smokers. Relaxing current restrictions on the sale of snus is more likely to produce a net benefit than harm, with the size of the benefit dependent on how many inveterate smokers switch to snus

Full body illusion is associated with widespread skin temperature reduction

A central feature of our consciousness is the experience of the self as a unified entity residing in a physical body, termed bodily self-consciousness. This phenomenon includes aspects such as the sense of owning a body (also known as body ownership) and has been suggested to arise from the integration of sensory signals from the body. Several studies have shown that temporally synchronous tactile stimulation of the real body and visual stimulation of a fake or virtual body can induce changes in bodily self-consciousness, typically resulting in a sense of illusory ownership over the fake body. The present study assessed the effect of anatomical congruency of visuo-tactile stimulation on bodily self-consciousness. A virtual body was presented and temporally synchronous visuo-tactile stroking was applied simultaneously to the participants' body and to the virtual body. We manipulated the anatomical locations of the visuo-tactile stroking (i.e., on the back, on the leg), resulting in congruent stroking (stroking was felt and seen on the back or the leg) or incongruent stroking (i.e., stroking was felt on the leg and seen on the back). We measured self-identification with the virtual body and self-location as well as skin temperature. Illusory self-identification with the avatar as well as changes in self-location were experienced in the congruent stroking conditions. Participants showed a decrease in skin temperature across several body locations during congruent stimulation. These data establish that the full-body illusion (FBI) alters bodily self-consciousness and instigates widespread physiological changes in the participant's body

Posing for awareness: Proprioception modulates access to visual consciousness in a continuous flash suppression task

The rules governing the selection of which sensory information reaches consciousness are yet unknown. Of our senses, vision is often considered to be the dominant sense, and the effects of bodily senses, such as proprioception, on visual consciousness are frequently overlooked. Here, we demonstrate that the position of the body influences visual consciousness. We induced perceptual suppression by using continuous flash suppression. Participants had to judge the orientation a target stimulus embedded in a task-irrelevant picture of a hand. The picture of the hand could either be congruent or incongruent with the participants' actual hand position. When the viewed and the real hand positions were congruent, perceptual suppression was broken more rapidly than during incongruent trials. Our findings provide the first evidence of a proprioceptive bias in visual consciousness, suggesting that proprioception not only influences the perception of one's own body and self-consciousness, but also visual consciousness